Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 HOLDING A MIRROR TO THE GOVERNMENT! EXPERIENCES WITH CITIZEN REPORT CARDS 1

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 OVERVIEW OF PRESENTATION The Context – Why Citizen Report Cards? The Concept – What is a Citizen Report Card? The Method – How Citizen Report Cards are designed The Impact – Major outcomes of Citizen Report Cards The Lessons – Critical experiences & takeaways 2

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 CONTEXT: WHY CITIZEN REPORT CARDS? Lack of Accountability When the government holds a monopoly over service provision, citizens are unable to find alternatives if service is ineffective Lack of Responsiveness As service providers, governments only take into account a supply-side perspective and do not account for the experiences of actual users of their services (the demand side) Lack of Incentive Within the government hierarchy, the incentives of individual services providers can be misaligned, which serves to block demand-driven improvements 3

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 LESSONS FROM A SCHOOL REPORT CARD Power of MEASUREMENT Power of COMPARISON An Opportunity for REFLECTION A trigger for CHANGE & IMPROVEMENTS 4

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 CONCEPT: WHAT IS A CITIZEN REPORT CARD? 5 Background Work and Preliminaries Implementation of Citizen Report Card Continuous Benchmarking and Periodic Review Successful Citizen-Driven Reform Creation of Institutional Self-Monitoring Mechanisms Dialogue with and response of service providers Engagement with stakeholders Engagement in various forms of advocacy Dissemination of findings

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 6

Elements of the CRC Process Preliminary Work: Identify the issues, ascertain feasibility of CRC, define scope of action, design survey, and frame the sample Implementation of CRC: Collect user feedback, engage with service providers, rate services, analyize and interpret data, and produce reports Setting an Agenda for Reform: Actively engage all stakeholders (users, citizens, service providers, policymakers, etc.), disseminate findings, and promote advocacy (civil society, media, etc.) Benchmarking and Reform: Affect citizen-driven reform and maintain a continuous benchmarking process through periodic review Self-Monitoring Institutions: Encourage service providers to be accountable and monitor their own effectiveness without requiring external impetus Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 7

METHOD: STAGES IN CITIZEN REPORT CARD DEFINING SCOPE OF ACTION PREPARATIONS AND COLLECTING CITIZEN FEEDBACK RATING OF SERVICES DIALOGUE AND RESPONSE OF AGENCIES CITIZEN ENGAGEMENT IN REFORM PERIODIC BENCHMARKING AND PUBLIC REVIEW 8

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20, METHOD: ADDITIONAL DIMENSIONS Who can implement a CRC? Individual Civil Society Organizations – PAC & TIB Civil Society Partnerships – Peoples Voice Project, PANE Independent Multi-Stakeholder Consortiums – Kenya, Tanzania Governments – Internal ( Vietnam ) & Open ( Delhi ) Are there tools to supplement a CRC? Depending on the needs and scale of the community monitoring project, a Community Score Card (CSC) can be undertaken either in place of or to supplement a CRC CRCs are best suited for gathering large-scale feedback (e.g., a city), while CSCs are designed for small- scale projects (e.g., a village school)

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 IMPACT: THE POWER OF MEASUREMENT & COMPARISON CITIZEN REPORT CARDS AND HEALTH 10

Tajikistan - Gauging Satisfaction with Different Dimensions of Health Services Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,

Kyrgyzstan – Rating Various Aspects of Service at Oblast Hospitals Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,

Bangalore- Public Hospitals 1999 (general households) Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 The bribery matrix Proportion in sample claiming to have paid a bribe (%) (1994)17 Proportion in sample claiming to have paid a bribe (%) (1999)24 Average payment per transaction in Rupees (1994)396 Average payment per transaction in Rupees (1999) Major finding: Percentage of users paying a bribe has increased, while amount of bribe (in Rupees) has decreased

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 Bangalore Government Hospitals - Quality/Reliability Some Findings 99% of slum respondents report doctors chamber as clean 34% report presence of doctors at the time of visit 37% said all the required medicines were available 11% report being given expired medicine 69% completely satisfied with the time taken by the government hospital staff to attend to them Follow up Board of visitors constituted Help desk for patients Constant internal reform from the health department and health authorities 14

Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,2011 Counting and discussing instead of just shouting Presenting strengths and weaknesses – pat & slap Enables policy makers set policy priorities Helps agency managers assess service efficiency Provides a bridge for civil society to dialogue on citizens priorities Transmits the voice of the poor without intermediation by representatives LESSONS: MAJOR POINTS OF INFLUENCE 15

contact & other information contact & other information E-learning course on CRC at Cd copies available if you want to copy it Film on CRC available – few copies – copy if required from my laptop Paf website – – Dr Sita Sekhar, OSF Convention, Johannesburg, July18-20,